leg up-lifts

These feet may be made for walkin', but nature could have done a better job designing legs for pregnancy. Those kielbasa sausages masquerading as your ankles are one clue to the design flaw. So are nighttime leg cramps.

"Some women notice discomfort in their legs even before they know they're expecting," says Luis Navarro, M.D., founder and director of the Vein Treatment Center in New York.

Achey varicose veins is a common symptom. Blood volume increases dramatically, and hormones make vein walls more elastic, setting women up for enlarged veins, which show as purple-blue distentions on the skin. "Heredity largely determines who will get varicose veins," says Navarro, "but all pregnant women are at risk because the growing uterus presses on the large blood vessel called the inferior vena cava, slowing the return of blood from the legs to the heart."

When blood pools in the legs, pressure builds and the veins become swollen and distorted. Tiny valves in the veins that keep blood from returning to lower extremities may fail. Additional pregnancies may have a cumulative effect, and obesity can worsen the problem.

The legs have deep veins that carry about 90 percent of the blood, but it's the surface veins, visible below the skin and less supported by muscles, that most often become enlarged and twisted. Putting feet up when possible and sleeping with feet elevated above the level of the heart help minimize pressure on veins in the lower legs. But Navarro says the best thing you can do — starting with day 1 of pregnancy — is wear graduated maternity hose, which compress the leg more at the ankle and less at the thigh.

The treatment

If you do develop varicose veins, don't freak. Though uncomfortable and unsightly, they're seldom dangerous and not necessarily permanent. "Approximately two-thirds will vanish six to eight weeks after delivery," says Navarro. "The rest can be treated with surgery, which closes the veins that have leaky valves; and with laser therapy, which erases the spiderlike purple-blue marks."

Call your doctor if veins in your legs are swollen, red, painful, warm to the touch or accompanied by fever, rash, sores on the leg and/or circulation problems in your feet; or if your legs swell and you have a history of high blood pressure.

Nighttime leg cramps are probably associated with poor circulation and can be relieved by using a heating pad or by extending the affected leg, pressing hard with the heel and flexing the toes up toward the ankle.

Give your legs plenty of TLC. How you treat them during pregnancy will affect how they look and feel years down the road.